A study of Immunoglobulins,Complements and Some Hematological Parameters Levels in Thalassemic Patients in Related Bacterial Infections

Background: Thalassemia and abnormal hemoglobin are the most common genetic disorders and are considered health problems in many developing countries. Beta-Thalassemia major is the most familiar type, in which the beta-globin chain synthesis is impaired. Objective: To evaluation the concentrations of immunoglobulins  IgM, IgG and  IgA also the complements  C3 and C4 between β-Thalassimic children patients and control group, and find the differences of some hematological parameters between the two  groups, finally, isolation of some bacterial species causes the bacterial infections. Patients and Methods: The present study was performed on 40 β-thalassemia major children who were registered in the thalassemia center at Al-Karama teaching hospital in Baghdad and 20 healthy children as a control group from the period of September 2015-Augest 2016, the serum immunoglobulins (IgG, IgM, IgA) and complement C3, C4 levels were measured also blood culture was done to identify the causative infection. Results: The mean serum concentrations of IgM, IgG and IgA in β-thalassemia major children were 1834.1 ± 312.2, 134.5 ± 40.3 and 212.7±89.6, respectively, and they were increased significantly (p≤0.05). The mean serum concentrations of C3 and C4 were consistently decreased in children and there were no significant differences (p≤0.05) between the two groups. The mean Hb of β- thalassemic children was 8.32±0.91 g/dl  and this lower from the level of control, RBC count is also low 3.7±0.7 but the levels of  WBCs  was higher in β- thalassemic children 10.4±1.67, several types of bacterial specious were isolated included  Staphylococcus aureus 30% (12 patients) , Escherichia coli 25%(10 patients) , Streptococcus pneumoniae 17.5% (7 patients), Salmonella enteritidis 10% (4 patients), Serratia  marcescens  7.5% (3 patients), Pseudomonas aeruginosa 5%(2 patients), Klebsiella pneumoniae 2.5%(1 patients) and Haemophilus influenza 2.5%(1patients).  Conclusion: The alteration in serum immunoglobulins and complements levels in thalassemia major children probably can be due to marked heterogeneity of the patients,

Determination and Prevalence of Bacterial and Fungal Keratitis among Patients in Baghdad City

The study included 234 patients attended to Iben AL-Haithem hospital of ophthalmology in Baghdad city having microbial keratitis , at age of (18-81) years for the period from September 2017- April 2018 . there were 147 ( 63% ) patients with bacterial keratitis and 87 (37%) with fungal keratitis . Men with bacterial keratitis represented 60% (88) and women 40% (59) ,while men with fungal keratitis were 61% (53) and women 39% (34), the number of the patients with bacterial keratitis were 82(56%) and 51(59%) with fungal keratitis from Baghdad while the internally displaced were 62(44%) with bacterial and 36(41%) with fungal keratitis , the percentage of patients with bacterial keratitis and fungal keratitis were both (34%) at mean age of 73 ± 2.3 y . Most patients with bacterial keratitis recorded having diabetes mellitus(39%) while the diabetic with fungal keratitis represented (41%) , The results revealed that gram positive bacteria was 102 (69%) and gram negative 45 ( 31%) , S.aureus was the most common cause of bacterial keratitis42(29%), followed by S.epidermidis 36(24%) then Streptococcus spp. 24(16%) , Pseudomonas spp. 17 (12%) , Proteus, spp. 13 (9%) , Escherichia coli 9(6%) and Enterobacter spp 6(4%) while Aspergillus fumigates represented 26(30%) as the most common cause of fungal keratitis , Aspergillus flavus 19(22%) , Aspergillus niger 16(18%) , Pencillium spp 11(13%) , Fusarium oxysporium. 8(9%) , Fusarium solani 5(6%) and Candida spp 2(2%) . S. aureus isolates were susceptible to Cloramphenicol and Ciprofloxacin (83%) while they were resistant to Clindamycin (57%) . S.epidermidis isolates were susceptible to Cloramphenicol and Amikacin (86%) ,Streptococcus spp were susceptible to Tetracycline and Clindamycin (88% ,83%) , Pseudomonas spp showed their high susceptibility to Tetracycline(96%) followed by Cloramphenicol and Ciprofloxacin (88%) both each, Enterobacter spp were susceptible to Tetracycline and Gentamicin (100%) while E.coli were susceptible to Cloramphenicol (100%) followed by Ciprofloxacin and Gentamicin (89%) both, fungal isolates were susceptible to all types of antibiotics used in the study as (98%) of Aspergillus spp isolates were sensitive to Itraconazole (98%) Voriconazole, Amphotericin B and Natamycin (95%,93% ,92%) respectively, Pencillium spp. were sensitive to Amphotericin B (100%) then Natamycin and Itraconazole (91%) both, Fusarium spp were sensitive to Natamycin and Itraconazole (100%) , Candida isolates were sensitive (100%) to Amphotericin B, Natamycin and Voriconazole